youth resiliency & mental health workshop - dr. jean clinton

Resilience in Youth

Jean M Clinton B.Mus MD FRCP(C)McMaster University and Children’s HospitalOfford Centre for Child Studies

OUTLINE

The Adolescent Brain The Prickly Brain Resilience Asset Building

Kids Today

"The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in placeof exercise. Children are now tyrants, not the servants of their households. They no longer rise when elders enter the room. Theycontradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and tyrannize their teachers."

PLATO

Adolescents: Why DO they do the things they do?

Key Messages

‘UNDER CONSTRUCTION” Teens need MORE of our time, not

less.

What we THINK, affects how we FEEL, affects how we ACT (TAFFY)

The majority of adolescents do well YET

The Paradox Measures of most abilities indicate that

adolescence is the healthiest and most resilient period of the lifespan.

Yet overall morbidity and mortality increases 200-300 times from childhood to late adolescence.

Primary causes of death and disability related to

Problems with control of behaviour and emotions

03-013

The Hostage Brain , Bruce S. McEwen and Harold M. Schmeck, Jr., 1994.

THE BRAIN FAIRY

Diamond & Hopson, 1998

“The nerve cell, or neuron resembles a miniature tree…” (p. 21)

SYNAPSE

The Three Brains Reptilian Complex (oldest)

Homeostatic maintenance body: breathing, digestion, reproduction.

Fight Flight System Ritualistic and hard to

change

Limbic System Primary center for control

of emotion, reward and goal motivation

Amygdala, hippocampus, anterior cingulate insula…

Neo-cortex (newest) Cerebral cortex Logical thinking Planning Speech Control -- Regulation INHIBITION MACHINE

Down-regulates heightened emotions and urges

“Executive Functions” Governing emotions Judgment Planning Organization Problem Solving Impulse Inhibition Abstraction Analysis/synthesis Self-awareness* Self-concept* Identityand Spirituality

Williamsgroup, 2003: Please credit Protecting You/Protecting Me (PY/PM)

*Self- “everything”

The Frontal Lobes

Frontal Lobes for Behavioral Control, Birth - 21

Age

Overproduction and Exuberance Pruning

The Brain Bonsai

The Fear Response: Fight or Flight and Stress

Visual Cortex

Visual Thalamus

Amygdala

Scientific AmericanThe Hidden Mind, 2002, Volume 12, Number 1

Amygdala

Hippocampus

EmotionalStimulus

PIT

Cortisol CortisolCRF

ACTH

Amygdala Hippocampus

AdrenalCortex

HypothalamusPVN

+ + - -

LeDoux, Synaptic Self

03-002

Amygdala and Hippocampus

Anterior Cingulate Cortex

Limbic System for Birth - 21

AgeYears

What emotion do you see?

Deborah Yurgelun Todd McLean Hospital Belmont, Mass (2004)


Adolescents use the Amygdala (fight or flight response) rather than the Frontal Cortex (used by older adults) to read emotions

Teens are more likely to Teens are more likely to misinterpret misinterpret facial expressions facial expressions of emotionof emotion

See anger when there isn’t angerSee anger when there isn’t anger

Process in the amygdalaProcess in the amygdala

May react quicklyMay react quickly

Communication Gap


“Emotional Brain”

Development

Emotional brain dominates

Prefrontal cortex is not ready to take charge

Emotional brain seeks pleasure, in the form of novelty, excitement, and risk


ACC The “Oops Centre”

The Cognitive Affective Balance

Early Adolescence Early Adulthood

Ideally!

KEY: Not the overall balance that matters, it is the flexibility to shift when needed

SCENARIOS

What we THINK….

Affects what we FEEL…

Affects how we ACT….

From Deficit to Resiliency

The Deficit/Risk Model

• Historically, the social and behavioural sciences have followed a problem-focused approach to studying human and social development.

• As a result, the helping community has been preoccupied with the deficit or at-risk paradigm for understanding and serving children in trouble and their families.

Wayne Hammond :Resiliency Canada 2006

Deficit ThinkingSpecialtyDiagnosis Reaction

Education Disruptive Reprimand, suspend, expel

Social Work Dysfunctional Intake, manage, discharge

Corrections Delinquent Adjudicate, punish, incarcerate

Behaviourism Disordered Assess, conditioning, time out

Medicine Diseased Diagnose, drug, hospitalize

Psychopathology Disturbed Test, treat, restrain Wayne Hammond :Resiliency Canada 2006

To see all individuals as “at promise” rather than “at risk” is a fundamental shift that means facilitating rather than fixing, pointing to health rather than

dysfunction, turning away from limiting labels and diagnosis to

wholeness and well-being.

“ If we think we are fragile and broken, we will live a fragile, broken life. If we believe we are strong and wise, we will live with enthusiasm and courage. The way we name ourselves colors the way we live. Who we are is in our own eyes. We must be careful how we name ourselves.”

Wayne Muller

What is Resilience? Anne Masten

Positive patterns of adaptation in the context of past or present adversity

Doing OK despite risk or adversity Positive outcomes from high risk context Recovery from Trauma Overcoming adversity to succeed in life Unexpectedly positive development

MASTEN

MAsten

The Short list

Effective Parenting Connections to

other caring and competent adults

Problem solving skills

Self-regulation skills

+ve self perception

Life has meaning and hopefulness

Spirituality Talents valued by self or

society Socioeconomic

advantage Community

effectiveness and safety Connections with

prosocial and competent peers

Masten

Principles of Resilience Belonging – need to engage and build trust

Building Capacity – recognize strengths and passion

Independence – promote ability to creatively draw upon internal and external resources

Purpose – nurture belief that “my life” has meaning

The core of strength-based resilient prevention is paying attention to what works and identifying strengths rather than deficits in the youth.

It focuses on what is important and not just what is urgent

It takes a whole community practicing a

strength-based philosophy when working with youth at all levels of implementation of preventative interventions

A Resilience Approach

A Resilience Approach Needs to be process and relationship

oriented with less dependency on techniques and professionals.

Strength-based practice is about partnering in order to help youth identify and use their own strengths and resources to overcome obstacles and live empowered lives.

Characteristics of Resilience-Based Practice

1. A focus on language – “Language is not innocent” (Anderson, 1996)

2. A focus on story – Stories of self guide how people act, think, feel, and make sense of their past and present lives

3. A focus on strengths, abilities, and resources – a firm and committed belief that all people of all ages, and all families possess ability, competence, and other special qualities regardless of their life experience or current situation

Resilience-Based Practice

4. A focus on collaboration – acknowledging that people have a view of their current situation, its potential solutions and ideas about how the change process should unfold

5. A focus on relationship – walking with as opposed to dictating

Critical Components of ChangeAn analysis of 40 years of research found the

best predictor of successful change are two factors:

1) engagement in meaningful relationships

2) engagement in meaningful activities

83% of change involves these two factors17% is a result of technique

Change does not come from special powers from professionals

Change happens when a person uses their inherent strengths and resources and are supported by relationships that take your innate goodness as a given

Change happens when you create a plan that is tailored to the person’s ideas and therefore inspires the hope necessary for action

Effective, Strategic, Prevention Intervene early in cascade to prevent

snowballing or co-morbidity Promote competence and regulatory

capacity, both self and social –regulatory Decrease trauma exposure and increase

protection for youth in at risk environments Strengthen scaffolds during periods of

change for adolescents Provide opportunities, mentors and second

chances

MASTEN

The Relational Landscape is Changing.

Children have fewer social, cognitive and emotional interactions, with fewer

people.

The impact of “modern life” on the developing child has yet to be fully

understood

Dr Bruce Perry www.childtrauma.org

Poverty of Relationships

The compartmentalization of our culture has resulted has resulted in material wealth yet poverty of social and emotional opportunity

Dr Bruce Perry www.childtrauma.org

Vision and Mission of Search InstituteCreate a world where all children are

valued and thrive.

To provide leadership, knowledge and resources to promote healthy children, youth and communities.

Two Shifts

Beyond programs

Relationships

Second ShiftSecond Shift

to

From fixing young

people’s problems

First ShiftFirst Shift

Promoting young

people’s strengths

to

From To

The Asset-Building Difference

Young people’s problems Young people’s strengths

Professionals’ work Everyone’s work

Young people absorbing resources Young people as resources

Programs Relationships

Troubled young people All young people

Accountable only for own Accountable as well for behavior other adults’ behavior

Incidental asset building Intentional asset building

Blaming others Claiming responsibility

3 General Strategies for Promoting Asset BuildingBuild RELATIONSHIPS with children

and youthCreate positive and supportive

ENVIRONMENTSConnect asset building with programs

and practices

THRIVE

The Canadian Centre for Positive Youth Development

1-800-265 2680

www.thrivecanada.ca

The Search Institute www.search-institute.org

Slides will be available at:

www.ascy.ca

www.offordcentre.com

youth resiliency & mental health workshop - dr. jean clinton

Health & Medicine